Non-Urgent Pre-Service and Concurrent Claim
- One-Level Appeals Procedure: Where the Claim
Administrator maintains a one-level appeals procedure,
you will be sent a notice of decision on review
within 30 days of receipt of the appeal.
- Two-Level Appeals Procedure: Where the Claim
Administrator maintains a two-level appeals procedure,
you will be sent a notice of decision on review
within 15 days of receipt of the appeal. If more time
or information is required to make a decision, the
Claim Administrator will specify what additional
information is required and it may request up to an
additional 15 days.
If you are dissatisfied with the outcome of your first
appeal, you may file another appeal with the applicable
Claim Administrator within 180 calendar days
from the date on the notice of the letter denying your
first appeal. You will be sent a notice of decision on
review of your second appeal within 15 days from
receipt of the second appeal.